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General NPI Number Information
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NPI Number | 1689716565
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Entity Type | Organization
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Legal Business Name | TINA JOYCE DO LLC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 01/14/2013
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Provider Practice Location Address
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Address Line | 8007 AUBURN RD SUITE 3
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City | PAINESVILLE
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State | OH
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Zip | 44077-9600
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Country | US
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Telephone | 440-375-5520
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Fax | 440-375-5520
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Provider Business Mailing Address
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Address Line | 8007 AUBURN RD SUITE 3
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City | PAINESVILLE
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State | OH
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Zip | 44077-9600
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Country | US
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Telephone | 440-375-5520
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Fax | 440-350-0955
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TINA MARIE TRZASKA JOYCE
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Credential | DO
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Telephone | 440-375-5520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34-008375
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License Number State | OH
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